Responsiveness of the Hexoskin Smart Shirt to Detect Pharmacological Lung Volume Reduction at Rest and During Exercise in People with Copd

• Main Author: Mujaddid, Ahzum
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2023
• Subjects: Anticholinergics; Chronic obstructive pulmonary disease; Exercise; Exercise, kinesiology, and sport sciences; Kinesiology; Medicine; Respiration
• ISBN: 9798382618050

Introduction: The role of wearable biosensor technology for the health monitoring of people with chronic respiratory diseases, like chronic obstructive pulmonary disease (COPD), has increased tremendously in recent years. Though many wearable health monitoring devices are commercially available, very few have been clinically validated nor are they able to measure changes in ventilatory parameters and operating lung volumes, key physiological indicators of lung health and disease progression for people with COPD. In light of this, Hexoskin is a commercially available wearable smart shirt that is unique in its potential to measure changes in ventilatory parameters and operating lung volumes. Objectives: To determine 1) the responsiveness of Hexoskin to measure bronchodilator-induced changes in tidal volume (VT), ventilation (V’E), respiratory rate (RR), inspiratory capacity (IC) and inspiratory reserve volume (IRV) at rest and during exercise in people with COPD compared to a laboratory (gold)-standard respiratory monitoring device, a Vmax Encore Metabolic Cart (Vmax); and 2) the ability of Hexoskin to validly measure VT, V’E, RR, IC, and IRV at rest and during exercise in people with COPD, compared to Vmax. Methods: Ventilatory parameters (VT, V’E, RR) and operating lung volumes (IC, IRV) were simultaneously collected using Hexoskin and Vmax in 6 adults (4 males, 2 females) with COPD (FEV1 % predicted = 53.8% ± 17.7; FEV1/FVC = 0.44 ± 0.13). Participants performed spirometry and a 3-minute constant rate stair stepping test (3-MIN CRSST) before and 60-min after inhalation of nebulized Combivent® (500 mcg/2 mL ipratropium bromide + 2.5 mg/2.5 mL salbutamol), a powerful short-acting bronchodilator. Results: Both Hexoskin and Vmax recorded exercise-induced increases in VT, V’E and RR under both pre- and postbronchodilator conditions, whereas only Vmax documented decreases in IRV from baseline to the end of the 3-MIN CRSST. Neither Hexoskin nor Vmax documented a change in IC from rest during the exercise both before and after inhalation of nebulized Combivent®. Significant correlations were observed between paired Hexoskin and Vmax-derived measures of VT (R2 =0.27, p<0.001) V’E (R2 =0.54, p<0.001), and RR (R2 =0.62, p<0.001) within the pooled data from baseline and exercise under both pre- and post-bronchodilator conditions; however, no such associations were observed between paired Hexoskin and Vmax-derived measures of IC (R2 =0.03, p=0.194), and IRV (R2=0.06, p=0.143). Single-dose inhalation of nebulized Combivent® had no effect on Hexoskin or Vmax-derived measures of V’E, VT, RR, IC and IRV at baseline, during exercise or recovery. There was also no association between bronchodilator-induced changes in Hexoskin and Vmax-derived measures of VT (R2 =0.05, p=0.591), V’E (R2 =0.02, p=0.566), RR (R2 =0.02, p=0.604), IC (R2 =0.02, p=0.454), and IRV (R2 =0.17, p=0.082) within the pooled data from baseline, exercise, and recovery. Conclusion:The preliminary results of this study (i) add to the growing evidence base supporting the use of Hexoskin as a valid remote monitoring device to document changes in ventilation and breathing pattern during daily life activities, like stair climbing, in people with COPD; and (ii) indicate that Hexoskin is neither a valid nor responsive tool to detect changes in operating lung volumes due to exercise and/or bronchodilator therapy in people with COPD.